Indentation After Rhinoplasty. Is It Easy to Fix? (photo)

Question

I got an open rhinoplasty 2 weeks ago. Since the first day I noticed a dent in the tip of my nose. The doctor told me if it continues he was going to fix it with a quick nose job with local anesthesia but it could resolves by itself. Do you know cases in which the dents have resolve by itself? Is the fix just a small surgery with a few stitches as he told me? In your experience when is the best time to a revision surgery to fix it? Is 4 months ok?

Kenneth Hughes, MD · Answer

The indentation will definitely change over the next several months to a year, and 4 months may be too early for a revision. Depending upon how the area looks after healing, filler may be appropriate as well.

Paul S. Nassif, MD · Answer

In general, the final result of a rhinoplasty is not evident for 18-24 months following surgery. 2 weeks is still soon after surgery, and you are very early in the healing process. It is best to wait at least one year before having any touch ups performed, especially if there is tip work involved. There will be swelling present from the first surgery that can interfere with your surgeon doing his or her best possible job. The ideal treatment option really depends on your individual circumstances. I would recommend waiting to see how you heal, and then follow up with your surgeon. I hope this helps, and I wish you the best of luck.

John M. Hilinski, MD · Answer

What you are pointing out in the nasal tip region might change as the months go on. I would just be patient for now. If the abnormal shadowing from the indentation persists, you might consider a minor revision or a permanent injectable to further contour the area. I would not recommend anything be done for at least 6-9 months. Wishing you the best of luck.

Jay Calvert, MD, FACS · Answer

That soft triangle dent is common.  I would wait for now, but you will either need several rounds of filler or, if you want to know its getting fixed, a small operation with some cartilage grafting.  However, the longer you wait, the more that can be done to improve the look of the nose.

Jeremy B. White, MD · Answer

Dear Mari, The contour deformity is apparent now and is probably due to very strong, thick lower lateral cartilages in an area where the skin can be thin. You are and will be swollen for quite some time though so you should wait at least 6 to 12 months before pursuing further surgery or injectable filler. Once swelling goes down, you might no longer notice the depression. It is hard, but try to be patient and wait this out. All the best!

John C. Ferguson, MD · Answer

When closing an open rhinoplasty, I have found that if I grab to much soft tissue in this area (the soft triangle) with my suture this indentation can occur. As the suture dissolves the indentation resolves. On one occasion where it persisted I placed a temporary filler. No further intervention was necessary, and she is 5 years out. Give it some more time.

Darryl J. Blinski, MD · Answer

Yes better to wait at least 6 months before a revision attempt. Which I believe you will need for more than just the dent. But wait.

Indentation After Rhinoplasty. Is It Easy to Fix? (photo)

Answers (7)